Orthopaedic and brain injuries over last 10 seasons in the National Football League (NFL): number and effect on missed playing time

OBJECTIVE: To examine trends in number and seriousness of major injuries in the National Football League (NFL) over seasons 2010–2019 and the effect of rule changes to injuries to the leg, back, arm and head. METHODS: We calculated, from publicly available weekly injury reports, the number of players that were injured and playing time missed, that is, the number of weeks on average that an injured player had to sit out, as a function of injury to a specific body part. Using classical time series analysis techniques, we fitted injury data with linear and non-linear functions. RESULTS: The number of major injuries to the leg, back, arm and head has not declined over the last 10 years. During this time period, time missed because of injuries to the head has shown a significantly increasing trend. Rule changes designed specifically to protect arm or head have, respectively, succeeded in shortening the time that the injured player misses, but the impact lasts only over a single season. CONCLUSIONS: Overall, our data support the argument that new, well-intentioned rules adopted every season by the NFL have been proven to be too weak to make the NFL game safer. Broad-based management of brain and orthopaedic injuries and adoption of preventative measures to reduce the number of players injured and the seriousness of their injuries are required in the modern NFL.